Open Access Review Article

Aflatoxins, Dairy Products Contamination in the Incidence and Development of Diseases in Children Population – A Short Systematic Review

Francisco José Mendes Dos Reis, Eliza Miranda Ramos, Antonio Marcos Jacques Barbosa, Daniela Granja Arakaki, Valter Aragão Do Nascimento

Asian Journal of Medicine and Health, Page 35-44
DOI: 10.9734/ajmah/2020/v18i730223

Aims: This study aimed to characterize a profile according to a systematic review when addressing the acute effects and side effects on child health and the importance of preventive measures for controlling food in the presence of aflatoxins and mycotoxins.

Methods: The method used was a systematic review. We conducted a systematic review of the SCOPUS, PUBMED, COCHRANE databases to identify all potential publications between the years 2005 and 2018. At the same time, short and extended abstracts were excluded. The language of the studies was in English and Portuguese. After this process, the selected articles were examined and the data extracted for analysis were 05 articles.

Results: The initial search resulted in 289 randomized experimental articles. the presence of liver cancer is represented as the primary effect of chronic toxicity related to high dose intake in an ordinary matter. The aflatoxins B1 promotes the formation of hepatocellular carcinoma and it can occur with lower doses than the standard established of 30 µg/kg.

Conclusion: This systematic review shows the need for food control regarding aflatoxins contamination, especially food targeting children, once the health damages can occur in both acute and chronic exposures, bringing growth and development impairment due to immune system disorders and frequent infections.

Open Access Original Research Article

Haematological Alterations among Cement Loaders in Port Harcourt, Nigeria

Ransom Baribefii Jacob, Chinyelu Obianuju Mba, Patience Deborah Iduh

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/ajmah/2020/v18i730218

Background: Exposure to cement dust without necessary precautions to prevent its inhalation is found to cause respiratory, dermatological, ocular as well as hematological problems and this is a matter of great concern to the health of cement loaders.

Aim of Study: This study was aimed at determining haematological alterations among cement loaders in Port Harcourt, Nigeria.

Study Design: Cross sectional study design.

Methodology: A total of 100 apparently healthy male subject consisting of 50 cement loaders and 50 non cement loaders aged between the ages of 20- 45years old were recruited for the study. Four millilitres (4 mls) of blood was collected aseptically from the antecubital vein of each participant using standard venepuncture technique into ethylene diamine tetra acetic acid (EDTA) anticoagulated vacutainer bottles with proper mixing to avoid blood clotting and then analysed using Sysmex haematology autoanalyser. Graphpad prism version 6.2 was used to analyse the data obtained.

Results: Results obtained showed a statistically higher value (p<0.05) in platelet count (p=0.0001), lower values (p<0.05) in haemoglobin concentration (Hb), Packed cell volume (PCV), Mean cell volume (MCV) and Mean cell haemoglobin (MCH) (p=0.0001). No significant difference (p>0.05) was observed in the mean red blood cell (RBC) count value (p=0.3110), white blood cell (WBC) count (p=0.8138) and mean cell haemoglobin concentration (MCHC) (p=0.0584) respectively.

Conclusion and Recommendation: This study has confirmed that there are haematological alterations among cement loaders in Port Harcourt, Nigeria and these alterations are attributed to inhalation of cement dust during work. It is recommended that cement loaders should be mandated to use appropriate personal protective equipment during work hours and around areas where cement dust are generated.

Open Access Original Research Article

Epidemiological Profile of End-Stage Renal Diseases in Riyadh, Saudi Arabia

A. A. Alkhlaif, A. K. Alsuraimi, A. A. Bawazir

Asian Journal of Medicine and Health, Page 16-27
DOI: 10.9734/ajmah/2020/v18i730220

Background/Aims: The Saudi Center for Organ Transplantation (SCOT) reported (2015) a total of 15,782 dialysis patients in Saudi Arabia. Out of these patients, 14,366 were treated via haemodialysis, whereas the remaining 1,416 underwent peritoneal dialysis.

Aims: This study aimed to assess common factors that led to ESRD among dialysis patients at King Abdullah’s Dialysis Care Project in Riyadh, Saudi Arabia.

Settings and Design: Cross-sectional hospital-based study was conducted in the period May-September 2017, in King Abdullah’s Dialysis Care Project in Riyadh, Saudi Arabia.

Methods and Materials: This was a retrospective registry-based study using secondary data from the registry at King Abdullah’s Dialysis Care Project in Riyadh, Saudi Arabia (South Center). Registered male and female adult dialysis patients at this centre were included in this study. Patient medical records including disease state, laboratory profiles, and medical complications were analyzed.

Statistical Analysis Used: Statistical Packages for Social Science (SPSS version 22) was used to analyse the data obtained. Various statistical analyses were conducted including means, frequencies, and regression analysis (odds ratio).A P-value of less than 0.05 was considered as significant in the study.

Results: A total of 300 patients (55% males and 45% females) were included in this study. The mean age of the sample was 53 years (±SD 16). The prevalence of overweight and obese ESRD patients were 26% and 30%, respectively. The high frequent co-morbidities among ESRD patients were hypertension (82%) followed by diabetes mellitus (57%). The results showed that out of 90% of dialysis complications, 10% were cases of infection.

Conclusions: ESRD is an important public health problem in Saudi Arabia with alarming in its annual rates. For a better understanding of the aetiology and specific risk factors provoking ESRD in Saudi Arabia, further studies need to be conducted.

Open Access Original Research Article

Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19

Violaine Guérin, Pierre Lévy, Jean-Louis Thomas, Thierry Lardenois, Philippe Lacrosse, Emmanuel Sarrazin, Natacha Regensberg-de Andreis, Martine Wonner

Asian Journal of Medicine and Health, Page 45-55
DOI: 10.9734/ajmah/2020/v18i730224

Aims: The challenge regarding COVID-19 is to prevent complications and fatal evolution. Azithromycin (AZM) and hydroxychloroquine (HCQ) have proven their antiviral effect in vitro. We aimed to assess the efficacy and safety of AZM alone or combined to HCQ, prescribed, at an early stage, in patients with Covid-19, in a primary care setting.

Study Design: Retrospective observational study.

Place and Duration of Study: Patients have been followed by private practitioners in France, between March and April 2020.

Methodology: Eighty-eight patients received either no or a symptomatic treatment (NST) (n=34) or AZM alone (n=34) or AZM+HCQ (n=20). The efficacy end point was the time to clinical recovery and the safety end point was the occurrence of cardiovascular events. To improve the evidence level, a case-control analysis was performed on a sample of 57 patients (19/group) matched for age, sex and BMI.

Results: The mean (SD) times to achieve clinical recovery were respectively 25.8 days (11.1), 12.9 days (13.4) and 9.2 days (9.3), showing a statistically significant difference between NST and AZM alone (p<0.0001) or AZM+HCQ (p<0.0001). The statistical difference between NST and AZM was confirmed (p=0.0149) as well as the difference with AZM+HCQ (p=0.0002). No cardiac toxicity was recorded in any patient. No statistical difference was shown between AZM and AZM+HCQ groups, although the dual therapy tended to be more effective in patients over 50 years, based on an analysis using the cox model.

Conclusion: AZM and AZM+HCQ favourably impacted the course of the disease. We need trials, ideally prospective/double blind, to show if a statistical difference can be evidenced with a broader group, and clarify the indications of each treatment depending on initial clinical presentation.

Open Access Short Research Article

Accuracy of Monofilament in the Assessment of Diabetic Neuropathy

Vasudha Sanklapur, S. Shruthi, Nazir Attar

Asian Journal of Medicine and Health, Page 9-15
DOI: 10.9734/ajmah/2020/v18i730219

Background: Diabetes Mellitus is one of the leading contributors of global burden of chronic diseases. Detection of diabetic end-organ damage, particularly during its early stages, is very crucial and significant. Peripheral neuropathy is a known vascular complication of chronic diabetes. Several modalities of detecting peripheral neuropathy clinically are available. The purpose of this study was to evaluate Semmes-Weinsten monofilament10gm in screening the diabetic peripheral neuropathy.

Aims and Objectives: To assess the accuracy of monofilament test in assessment of Diabetic neuropathy.

Materials and Methods: We analysed the data collected from 50 patients admitted in the medical wards or attending medical outxpatient department, diagnosed to have Diabetes, from august 2018 to august 2019. The results of three clinical tests, monofilament test, vibration (test) and ankle jerk (test), were performed. In the next phase nerve conduction velocity was examined in those with peripheral neuropathy. The results then compared with each other and with the gold standard nerve conduction velocity study.

Results: Data were pooled and coded in Microsoft Excel spreadsheet. R Version 3.4.1 and SPSS V.22 software was used to analyze the data. The sensitivity and specificity of monofilament test as in comparison with other clinical tests as well as the gold standard nerve conduction test was found to be 58% and 88% respectively. The sensitivity of achilles reflex was 30% and specificity being 80% in comparison with the nerve conduction velocity test. The sensitivity and specificity of vibration sense was 38% and 58% respectively. Hence the Simmes-Weinstein monofilament test was found to be more accurate test for clinical diagnosis of peripheral neuropathy in patients with diabetes.

Limitations: Study population was small.

Conclusion: This study showed that Semmes-Weinstein monofilament can be easily used as a simple and inexpensive device for screening for peripheral neuropathy.

Open Access Case Study

Congenital Melanocytic Hairy Nevi in a Child from North-Western Nigeria

Fatima Bello Jiya, Maryam Amodu- Sanni, Nma Muhammed Jiya, Dada Muhammed Aquib, Muhammed Umar, Mohammed Hassan Abba, Fa’iza Mu’azu Abubakar

Asian Journal of Medicine and Health, Page 28-34
DOI: 10.9734/ajmah/2020/v18i730221

Aim: To present the first report of a large congenital melanocytic nevus with satellite nevi in an apparently healthy child from Sokoto, North-Western Nigeria.

Presentation of Case: A three year old girl was brought to the paediatric out-patient clinic of Paediatrics department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto with complaints of darkened skin colour on the left side of the face and scalp, the left arm, lower back, buttocks, and thighs, and excessive hair growth over the same side of the face since birth. There were no neurological symptoms Physical examination findings revealed a well-nourished, not ill looking child. She had a hyper pigmented patch on the left side of the face extending from the lower jaw to the scalp, measuring 21 cm in its longest length, with hypertrichosis on the same site, and two distinct, firm, painless nodular lesions on the left temporal region measuring 3 mm and 4mm respectively. On the lower one-third of the left arm was a hairy, velvety area of hyperpigmentation measuring 2X3 cm in diameter. Other affected sites were the lower back, the gluteal region and the thighs. Her neurologic and other systemic examinations were normal. A diagnosis of large congenital facial melanocytic hairy nevus with multiple satellite nevi was made.

Discussion: Congenital melanocytic nevi are benign proliferations of melanocytic cells said to be present at birth or in the first two years of life. Large lesions are rare, they measure 20 cm or more and are said to occur more commonly on the trunk and thighs. The exact pathogenesis of congenital melanocytic nevi is yet, unknown. It is thought to occur as a result of a morphological error in the neuroectoderm during embryogenesis. Treatment of patients with large congenital melanocytic nevus may include surgical or non-surgical procedures as well as psychological interventions. Large lesions, multiple satellite lesions or paravertebral and axial locations are sometimes associated with the risk of neurological complications and malignant transformation.

Conclusion: Large congenital melanocytic nevi are uncommon skin lesions that can occur in apparently healthy children. Individualization of the patients with regards to treatment options and long term monitoring are imperative.